Prosthetic joint infection caused by Mycobacterium tuberculosis is extremely rare. It can mimic aseptic loosening or chronic infection with common bacteria, delaying diagnosis. We report a case of tuberculous infection in a total hip arthroplasty in a 55-year-old immunocompetent patient, revealed by prosthetic loosening. The diagnosis was confirmed by histology, culture, and molecular biology (GeneXpert). This case highlights the need to consider tuberculosis in the differential diagnosis of chronic prosthetic infections, particularly in endemic areas.